Romanian Healthcare Privatisation Stirs Debate

The situation in private healthcare in Romania could change radically this year if a controversial new healthcare bill is adopted, according to officials.

The draft law, which has been put out for public debate, would allow the privatization of all hospitals and public clinics, leaving a minimum package of services in state hands.

The public sickness fund, CNAS, is to be replaced with private insurers and contributions to a private healthcare contractor will become mandatory.

“The new law aims to radically change the healthcare system by introducing private principles into public system. I am sure it will be completed and passed this year,” the Health Minister, Ritli Ladislau, has said.

In a related development, President Traian Basescu recently stated that public hospitals should be transformed into joint stock companies or charitable institutions and in general, “the running of a hospital should be similar to a company”. 

Many medical professionals do not agree. “The state should continue to have an important responsibility when it comes to the public health. I’m not against the privatization in healthcare, but this shouldn't become the rule,” Vasile Astarastoae, head of the country’s medical council, CMR, said.

“The new law just allows the most vulnerable to be hit harder and increases inequalities,” he added.

Polls show that over 90 per cent of Romanians are unhappy with the services provided by the public system. Many blame problems in the healthcare system on an inefficient management system, while 42 per cent believe insufficient financing is to blame, according to a Iris Global Health survey.

On the other hand, most people do not welcome the government’s drive to privatise the ailing post-Communist healthcare system. 

Starting from January 1, a new levy obliges patients to pay for a portion of their treatment. The fee aims to bring in 378 million lei (€90 million), money that hospitals can then spend on better equipment or salaries.

“I am against this measure. Why I should pay more for treatment when the quality of the services is still poor?” former teacher Ion Petrescu, 67, asked.

Romania has been struggling to reform its public health sector, which has fallen into growing chaos as a result of chronic underinvestment. Hospitals are understaffed and are short of specialists and modern medical equipment. Low pay in the health sector has encouraged an exodus abroad of doctors and nurses.

The average salary of a junior doctor in Romania is around €300 a month. A doctor who gets work in Britain, by contrast, may expect to earn many times that figure.

Romania spends less on healthcare as a percentage of the budget than any other country in the European Union. This year Bucharest will spend some €12 billion, which is only around 4.5 per cent of its GDP on healthcare, almost half the EU average.

Unsurprisingly, Romania's healthcare system is considered one of the worst in Europe. In 2010 it ranked last among 33 countries, according to the European Healthcare Consumer Index.